Failure to Assess and Supervise Safe Vaping Practices for Medical Marijuana
Penalty
Summary
The facility failed to comprehensively assess and ensure safe vaping practices for a resident with a medical marijuana card who was observed vaping THC in his room. The resident, who had diagnoses including malignant cancer of the bladder, chronic pain, anxiety, and insomnia, was dependent on staff for some activities of daily living and experienced constant pain. Despite the resident's use of medical marijuana being known to some staff, there was no documentation in the physician orders or care plan regarding the use or method of administration of medical marijuana, nor was there an assessment for safe vaping practices. Smoking assessments conducted at various intervals indicated the resident was a non-smoker, and the option for vaping was not selected in the electronic assessment tool, resulting in the absence of a safe vaping assessment. The facility's director of nursing (DON) and assistant director of nursing (ADON) were unaware that the resident was vaping, and the DON stated that while the resident was provided a locked box for marijuana supplies, the facility did not inquire about the method of ingestion or monitor the use. The facility's medical cannabis policy required physician support, documentation, and care plan updates for medical cannabis use, and specifically prohibited vaporizing or smoking cannabis within the facility or on its grounds. Despite these policies, the resident was observed vaping in bed, and documentation in the medical record by a physician assistant indicated prior awareness of the resident's use of a vape pen for THC. The facility did not assess the resident for safe self-administration of vaping, did not update the care plan to reflect the use of medical marijuana, and did not monitor or supervise the resident's vaping activities, resulting in a failure to prevent potential accident hazards related to vaping within the facility.